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Sonography Introduction to Normal

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Curry: Sonography, 3rd Edition
Chapter 09: The Inferior Vena Cava

Test Bank

MULTIPLE CHOICE

1. The IVC can be divided into the following sections:


a. Suprahepatic, infrahepatic, and midhepatic
b. Hepatic, prerenal, renal, and postrenal
c. Hepatic, lumbar, renal, and gonadal
d. All of the above

ANS: B
The IVC is considered to have four sections, from superior to inferior: hepatic,
prerenal, renal, and postrenal.

REF: pg. 161 OBJ: Discuss the normal location and course of the IVC.
TOP: Anatomy and physiology

2. From inferior to superior, identify the veins that converge into the IVC.
a. Common iliac veins, lumbar veins, renal veins, and left and right suprarenal
veins
b. Common iliac veins, lumbar veins, renal veins, right gonadal vein, and hepatic
veins
c. Hepatic veins, renal veins, left and right gonadal veins, and left and right
suprarenal veins
d. External iliac veins, left suprarenal vein, right gonadal vein, renal veins, and
hepatic veins

ANS: B
Inferiorly, the IVC is formed by the common iliac veins. Moving superiorly, the
lumbar veins empty into the IVC, followed by the renal veins, right gonadal vein,
and hepatic veins. The left gonadal vein and left suprarenal vein frequently empty
directly into the left renal vein, not the IVC. The right gonadal vein is slightly
superior to the right renal vein and most often empties directly into the IVC as well.

REF: pg. 162


OBJ: Discuss the major tributaries that feed into the IVC, along with the organs
emptied by these tributaries. TOP: Anatomy and physiology

3. The inferior phrenic veins are located


a. at the same level as the hepatic veins.
b. superior to the hepatic veins.
c. inferior to the hepatic veins.

Copyright © 2011 by Saunders, an imprint of Elsevier Inc.


Test Bank 9-2

d. inferior to the middle hepatic vein only.

ANS: B
The inferior phrenic veins, the most superior branches of the IVC, drain the
diaphragm.

REF: pg. 163


OBJ: Discuss the major tributaries that feed into the IVC, along with the organs
emptied by these tributaries. TOP: Anatomy and physiology

4. The diameter of the normal adult IVC is approximately


a. 1 cm.
b. 1.5 cm.
c. 2.5 cm.
d. 3 cm.

ANS: C
The normal adult IVC is 2.5 cm in diameter. The diameter increases with the
Valsalva maneuver or inspiration and commonly decreases during expiration.

REF: pg. 163 OBJ: Discuss the normal location and course of the IVC.
TOP: Anatomy and physiology

5. Blood is moved forward through the veins by


a. gravity.
b. the force of the aorta.
c. valves, which close to prevent antegrade flow.
d. a decrease in thoracic pressure, which pulls the blood to the right atrium.

ANS: D
The venous circulatory system is a low pressure system compared to the arterial
system. The momentum of the blood during systole forces the venous valves to open
as the blood is pushed forward. Also, blood is pulled toward the right atrium by a
decrease in thoracic pressure.

REF: pg. 163 OBJ: Discuss the function of the IVC. TOP: Anatomy
and physiology

6. In a transverse scanning plane image, the left renal vein can be seen as a(n)
a. straight structure posterior to the SMA.
b. axial structure near the left kidney.
c. longitudinal, curvilinear structure anterior to the aorta.
d. oval structure that empties into the medial IVC.

ANS: C
In a transverse scanning plane, the left renal vein is seen as a longitudinal,

Copyright © 2011 by Saunders, an imprint of Elsevier Inc.


Test Bank 9-3

curvilinear structure that courses anterior to the aorta and posterior to the SMA and
empties into the IVC.

REF: pg. 165


OBJ: Discuss the sonographic appearance of the IVC and commonly visualized
tributaries.
TOP: Sonographic characteristics

7. In a sagittal scanning plane, the right renal artery can be seen as a(n)
a. longitudinal, curvilinear structure anterior to the axial IVC.
b. straight structure posterior to the AO.
c. round, short axis structure posterior to the longitudinal IVC.
d. oval structure anterior to the longitudinal IVC.

ANS: C
In a sagittal scanning plane, the right renal artery is seen as a round, short axis
structure posterior to the IVC.

REF: pg. 166


OBJ: Discuss the sonographic appearance of the IVC and commonly visualized
tributaries.
TOP: Sonographic characteristics

8. Where should the transducer be placed to visualize the common iliac veins?
a. On the right and left groin areas
b. Near the umbilicus
c. At the symphysis pubis
d. None of the above

ANS: B
The common iliac veins are most easily visualized in the transverse scanning plane at
approximately the level of the umbilicus, before they converge to form the IVC.

REF: pg. 165 OBJ: Discuss the normal location and course of the IVC.
TOP: Anatomy and physiology

TRUE/FALSE

1. The walls of the hepatic veins are brightly echogenic. ____

ANS: F
The hepatic veins demonstrate nondescript, or “naked,” walls.

REF: pg. 163


OBJ: Discuss the sonographic appearance of the IVC and commonly visualized
tributaries.

Copyright © 2011 by Saunders, an imprint of Elsevier Inc.


Test Bank 9-4

TOP: Sonographic characteristics

2. The hepatic veins are anechoic. ____

ANS: T
The hepatic veins often can be seen in the most superior portion of the liver as
anechoic, linear structures with nondescript walls. They originate in the liver and
empty into the IVC.

REF: pg. 165


OBJ: Discuss the sonographic appearance of the IVC and commonly visualized
tributaries.
TOP: Sonographic characteristics

3. Echoes thought to be associated with blood flow sometimes can be seen in the
IVC. ____

ANS: T
Small moving echoes often are visualized in the lumen of the IVC.

REF: pg. 163


OBJ: Discuss the sonographic appearance of the IVC and commonly visualized
tributaries.
TOP: Sonographic characteristics

4. The IVC courses through the liver. ____

ANS: F
The IVC sometimes may appear to course through the superior portion of the liver,
but it actually courses posterior to the liver.

REF: pg. 163 OBJ: Discuss the normal location and course of the IVC.
TOP: Anatomy and physiology

5. The hepatic veins can best be seen in the superior section of the liver. ____

ANS: T
The hepatic veins often can be seen in the most superior portion of the liver as
anechoic, linear structures with nondescript walls. They originate in the liver and
empty into the IVC.

REF: pg. 163


OBJ: Discuss the sonographic appearance of the IVC and commonly visualized
tributaries.
TOP: Sonographic characteristics

Copyright © 2011 by Saunders, an imprint of Elsevier Inc.


Test Bank 9-5

6. The gonadal veins are easily seen on ultrasound. ____

ANS: F
The gonadal veins are not consistently imaged with ultrasound.

REF: pg. 165


OBJ: Discuss the sonographic appearance of the IVC and commonly visualized
tributaries.
TOP: Sonographic characteristics

7. The right renal vein is easily seen on ultrasound. ____

ANS: T
The renal veins are consistently recognized with ultrasound.

REF: pg. 165


OBJ: Discuss the sonographic appearance of the IVC and commonly visualized
tributaries.
TOP: Sonographic characteristics

8. The lumbar veins are easily seen on ultrasound. ____

ANS: F
The lumbar veins are not consistently imaged with ultrasound.

REF: pg. 165


OBJ: Discuss the sonographic appearance of the IVC and commonly visualized
tributaries.
TOP: Sonographic characteristics

9. The inferior phrenic veins are easily seen on ultrasound. ____

ANS: F
The inferior phrenic veins are too small to be readily seen with ultrasound.

REF: pg. 165


OBJ: Discuss the sonographic appearance of the IVC and commonly visualized
tributaries.
TOP: Sonographic characteristics

10. The left hepatic vein is easily seen on ultrasound. ____

ANS: T
The hepatic veins are routinely visualized with ultrasound.

REF: pg. 165

Copyright © 2011 by Saunders, an imprint of Elsevier Inc.


Test Bank 9-6

OBJ: Discuss the sonographic appearance of the IVC and commonly visualized
tributaries.
TOP: Sonographic characteristics

11. The left common iliac vein is easily seen on ultrasound. ____

ANS: T
The common iliac veins are most easily visualized with ultrasound.

REF: pg. 165


OBJ: Discuss the sonographic appearance of the IVC and commonly visualized
tributaries.
TOP: Sonographic characteristics

12. The right hepatic vein is easily seen on ultrasound. _____

ANS: T
The hepatic veins are routinely visualized with ultrasound.

REF: pg. 165


OBJ: Discuss the sonographic appearance of the IVC and commonly visualized
tributaries.
TOP: Sonographic characteristics

COMPLETION

Indicate whether the IVC is posterior (P), anterior (A), medial (M), or lateral (L) to
the structure.

1. Intestines ____

ANS: P
The IVC is posterior to the intestines.

REF: pg. 160 OBJ: Discuss the normal location and course of the IVC.
TOP: Structure orientation

2. Body of the liver ____

ANS: P
The IVC is posterior to the body of the liver.

REF: pg. 160 OBJ: Discuss the normal location and course of the IVC.
TOP: Structure orientation

3. Right kidney ____

Copyright © 2011 by Saunders, an imprint of Elsevier Inc.


Test Bank 9-7

ANS: M
The IVC is medial to the right kidney.

REF: pg. 160 OBJ: Discuss the normal location and course of the IVC.
TOP: Structure orientation

4. Aorta ____

ANS: L
The IVC courses to the right of the aorta (right lateral).

REF: pg. 160 OBJ: Discuss the normal location and course of the IVC.
TOP: Structure orientation

5. Hepatic veins ____

ANS: P
The IVC courses posterior to the hepatic veins.

REF: pg. 160 OBJ: Discuss the normal location and course of the IVC.
TOP: Structure orientation

Copyright © 2011 by Saunders, an imprint of Elsevier Inc.


Another random document with
no related content on Scribd:
It was the street of the stranger from far-off lands, of able seamen
whose sturdy boots had knocked about the worst sections of Port
Said, Marseilles, Singapore, or Bilbao—a street where honest ships
poked their bowsprits up to its very edge, a long, floating barrier, a
maze of masts, spars, and rigging, of vessels safe in port, whose big
hulls lay still in the flotsam and jetsam and swill of the harbor, where
the hungry, garrulous gulls wheeled, gossiped, and gorged
themselves like scavengers.
There was an atmosphere of adventure, of the freedom of the sea
along its length, that the staid old business streets back of it could
not boast of; that charm, sordid as it was, that holds the sailor and
his nickels in port, close to his quay, for he rarely ventures as far
inland as the city’s midst. At night jewels of lights hung in the maze
of rigging, others gleamed forth a broad welcome from the saloons.
When these went out, only the jewels in the rigging remained,
leaving the old, busy street of the day dark and deserted, save for an
occasional prowler of the night—or a stray cat foraging for food.
There were women, too—fat ogresses in cheap finery, skeletons in
rouge and rags, their ratlike eyes ever watchful for their prey—and
now and then some shuffling human derelict, those who have no
definite destination, neither friends nor home nor bed nor bunk to go
to; worse off even than the poor sailor in port, robbed, cajoled,
flattered, tempted, and always enticed, down to his last nickel.
None knew them better than Enoch. Many an empty pocket he
brightened with a coin. Others he helped out of more serious
difficulties. Had he accepted all the chattering monkeys and profane
parrots he had been offered from time to time in grateful
remembrance, he would have had enough to have started a bird-
store.
It was along this street that Ebner Ford picked his way the next
morning to Enoch’s office, eager for the interview, and never more
confident of selling him enough of his laundry stock, to be rid of old
Mrs. Miggs and her lawyer forever.
At five minutes to ten his lean figure might have been seen dodging
among the trucking, slipping around crates and bales, and only
stopping now and then to verify the address on Enoch’s note.
So elated was he over the prospect of the interview that he entered
Enoch’s building whistling a lively tune, continued snatches of it up in
the shaky elevator, insisted he had “an appointment at ten with Mr.
Crane,” and was led half-way down the corridor by the Irish janitor to
Enoch’s modest door, which he opened briskly with a breezy “Well,
neighbor, ain’t a minute late, am I?” and with a laugh, ending in a
broad, friendly grin, shot out his long hand in greeting.
Simultaneously Enoch swung sharply around in his desk chair with a
savage glance; not only did he refuse the proffered hand, but left his
visitor staring at him bewildered.
“Sit down!” snapped Enoch.
“Well, say!” drawled Ford. “Ain’t you a little mite nervous this mornin’,
friend?”
“Sit down!” repeated Enoch curtly, indicating the empty chair beside
his desk. “Do not delude yourself for an instant, sir, that you are here
to interest me in your laundry stock.”
“Well, that beats all,” declared Ford. “You to be all-fired interested in
your note. That’s what you said, wa’n’t it?”
“I’ve been enlightened as to the precise value of that laundry stock of
yours, sir,” came Enoch’s sharp reply—“your gilt-edged securities
relative to the Household Gem as well.”
Ford started.
“Have, eh? Well, it’s at par. That’s what you wanted—er—that’s what
you said you wanted,” he blurted out, slinking into the empty chair
and fumbling his dusty derby nervously.
“Well, neighbor, ain’t a minute late, am I?”
“Par!” snapped Enoch. “It’s at zero, and you know it. Below zero, I
should say, judging from all reports.” And before Ford could reply:
“Let us come to the point. You are in arrears for your rent, sir.”
Ford gaped at him in amazement.
“I refer, sir, to your apartment in Waverly Place; with the exception of
your first month’s payment, you have not paid a dollar’s worth of rent
since you moved in, not a penny, sir; rents are made to be paid, sir,
not avoided. You have not even made the slightest excuse or
apology to your landlord over the delay. Any other landlord would
have ousted you from the premises.”
Ford laid his dusty derby on the desk, planting his long hands over
his bony knees, his small eyes regarding Enoch with a curious
expression.
“Oh, I haven’t, have I?” he exclaimed. “Wouldn’t like to take a bet on
it, would you?”
“No, sir!” cried Enoch, squaring back in his seat. “You have not, not a
penny of it. Can you deny it?”
“What’s my rent got to do with you?” returned Ford. “You seem to be
almighty interested in other folks’ rents.”
“I’ve let you run on,” continued Enoch firmly, “so far without troubling
you.”
“Oh, you have, have you? Well, say, you take the cake! Talk as if you
owned the place.”
Enoch sprang out of his chair, his under lip shot forward.
“I do,” said he.
“You what?” gasped Ford, opening his small eyes wide. “You don’t
mean to tell me that there house is yourn?”
“Yes, sir—it’s mine, from cellar to roof. If you want further proof of it,”
he cried, wrenching open a drawer of his desk, fumbling among
some papers and flinging out on his desk the document of sale in
question, stamped, sealed, and witnessed, “there it is.”
“Well, I’ll be jiggered!”
“Jiggered or not, sir, your lease is up! You are behind in your rent,
and out you go.”
“Well, hold on now; I guess we can fix up this little matter,” returned
Ford, with a sheepish grin. “Hadn’t no idea it was you, friend, who
owned the house, or I wouldn’t have kept you waitin’.”
“I can assure you,” retorted Enoch, “there is no friendship concerned
in this matter. You will desist, sir, in calling me your friend; that phase
of our acquaintanceship never existed.”
For a moment neither spoke.
“See here, neighbor,” Ford resumed by way of explanation, and in a
tone that was low and persuasive, “with our increasin’ business I’ve
been under some mighty heavy expenses lately; new machinery has
exacted heavy payments. Our long list of canvassers on the road’s
been quite an item in salaries. S’pose I was to let you have a little of
our gilt-edged at par, as collateral for the rent?”
“Stop, sir!” cried Enoch. “Do you take me for a fool? Your laundry
stock is not worth the paper it is printed on—wasn’t at the time you
sold it to Mrs. Miggs.” He slammed his closed fist down on the desk.
“There is not a judge on the bench that would take four minutes to
decide a case against you for embezzlement. It’s as plain as
daylight.”
Ford stared at him dumfounded. He started to speak, but Enoch cut
him short in a towering rage.
“You’ve swindled my friend, Miss Ann Moulton, as well,” he cried.
“You took seven thousand five hundred dollars from her in payment
for your worthless stock—from a helpless lady—half she owned in
the world, you despicable hound—from a helpless woman.” Ford
reddened. “Half, I say—from the support of a sister who is ill—a
poor, pitiful wreck of a woman dying of consumption.”
“Oh! Now see here, Crane—go slow—let me explain.”
“Systematically swindled her, robbed her, talked her into it—
persuaded her until she gave you her check. Your kind stop at
nothing.” His voice rang out over the half-open transom and down
the corridor. Ford sat gripping his chair.
“I tell you, Miss Moulton ain’t lost a penny of her money,” he
stammered. “What I done for her I done out of neighborly kindness.”
“Stop, sir! Don’t lie to me. Answer me one question. How much of
Miss Moulton’s money have you got left?”
Ford glowered at him in silence.
“Answer me! How much have you got left? I intend to get at the
bottom of this damnable business. What you’ve got left of Miss
Moulton’s money, you’ll return to her.”
“Why, there ain’t a penny of it missin’,” declared Ford blandly, paling
visibly.
“You call a credit in your bank of five thousand two hundred and
some odd dollars, nothing missing? Where’s the rest?”
“Who told you that?” cried Ford, half rising, with a sullen gleam in his
eyes.
“Your bank!” cried Enoch sharply. “Its president, my old friend, John
Mortimer, told me. Under criminal circumstances such information is
not difficult to obtain.”
Enoch drove his hands in his pockets and started to pace the room.
Ford was the first to break the silence that ensued. His voice had a
whine in it, and most of the color had left his lean cheeks.
“You don’t want to ruin me, do yer?” he said thickly.
“Ruin you! No one can ruin you! You were born ruined! Answer me—
where’s the rest of Miss Moulton’s money?”
“Spent,” faltered Ford. “You don’t suppose a man can live on nothin’,
do yer? We all have our little ups and downs in business.
Fluctuations, they call ’em. Why, the biggest men with the biggest
business acumen, in the biggest business deals in the world have
’em. I ain’t no exception. That’s what all business is—chuck full of
little ups and downs. No man ever complains when business is
boomin’—only boomin’ is never regular. Good times pay for the bad.
A feller has to have grit to weather ’em. Then, if we didn’t risk nothin’,
we wouldn’t have nothin’. What does the Bible say? Sow and ye
shall reap.”
His voice faltered weakly.
“See here,” returned Enoch. “If I’ve got the slightest pity for you, you
personally are not responsible for it. Your stepdaughter is adorable.
Your wife is an honest woman.”
“There ain’t no better,” declared Ford meekly, moistening his lips with
a long finger that shook. “Girlie, too; her ideas ain’t mine, but I ain’t
got nothin’ agin her.”
“Good gad, sir! I should hope not. You have not a thought in
common! No dearer child ever lived! The very soul of honesty and
sincerity—a joy to my house, sir! A joy to every one who has come in
contact with her. That you should have so little love and respect for
her as to have acted as you have is astounding!”
“Girlie thinks an awful lot of you,” returned Ford, heaving a sigh,
Enoch’s tender allusion to his stepdaughter bringing with it his first
ray of hope. “Ever stopped to think,” he went on, with sudden
courage, “what this hull business will mean to her when she knows
it? See here, neighbor, you’re human, I take it. ’Tain’t human in no
man to crowd another feller to ruin like you’re crowdin’ me. It’ll like to
kill my wife when she hears it. As for girlie—well, you know what it’ll
mean to her—her little home gone, after all I’ve tried to do to make it
pleasant for ’em both. S’pose I was to tell you I’ll make good—only
you’ve got to give me time; that I’ll pay the rent and give every cent
back to Miss Moulton—square her up as clean as a whistle.”
Enoch turned sharply.
“On what, I’d like to know? And when? Out of the chimeric profits of
your vast laundry business, I suppose?”
“Hold on, neighbor, not so fast. I ain’t told you all. S’pose you was to
give me a couple of weeks’ time. I’ve got a little property I’ve been
bangin’ on to up-State. Four neat buildin’ lots on the swellest
outskirts of Troy—Fairview Park, they call it—neatest lookin’ place
you ever see; gas and water piped right from the city. I’ve been
waitin’ for the right party, but if I’ve got to sell now, Crane, I’ll do it. At
the lowest figger they’ll square up all these little differences between
us—Mrs. Miggs and Miss Moulton will get their satisfy, you’ll get your
rent, and girlie and Emma won’t know no more than if it never
happened.”
“You’ll pay Miss Moulton first,” declared Enoch firmly. “I am not
concerned with Mrs. Miggs’s affairs. Her own lawyer can attend to
them; as for the rent, I wish you to understand plainly, that if it was
not for your wife and stepdaughter——”
He ceased speaking. His teeth clenched. There was little doubt in
Ford’s mind that the worst was over; that Enoch was softening. He
already felt more at his ease, and for the first time leaned back in his
chair, and with the vestige of a forced smile crossed his long legs,
feeling that half the battle was won. What he exactly intended to do
he had not the slightest idea. Mrs. Miggs’s lawyer had given him until
noon. It was now past eleven. He decided to wire him: “Sending
check to-morrow.” Meanwhile Enoch had resumed his pacing before
him, muttering to himself words that even Ebner Ford’s quick ears
did not catch.
“How about this property of yours?” cried Enoch with renewed heat.
“Your four lots in Troy? You are rather vague, sir, about their value.
This Fairview Park you speak of? Anything there but gas and water-
pipes and a chance for the right party, as you say to come along?
Any railroad or street-car communication that would persuade any
one to build?”
Ford’s lean jaws, to which the color had now returned, widened in a
condescending smile over Enoch’s abject ignorance.
“Fairview Park!” he exclaimed with quick enthusiasm. “Why,
neighbor, it’s a bonanza! Has any one built on it? Well, I guess yes!
Take the Jenkins mansion alone—the candy king. Mansard roof
alone cost a fortune, to say nothin’ of a dozen other prominent
homes—brand-new and up to date—not a fence in the hull park.
Everybody neighborly. Course, soon as we get our railroad-station
things will boom. Quick transportation to the city and plenty of fresh
air for the children. Come to think of it, I was lucky to have bought
when I did. Got in on the ground floor, ’twixt you and me, and ain’t
never regretted it. Big men like Jenkins have been pesterin’ me a
dozen times to sell, but I’ve held on, knowin’ I could double my
money. Property has already advanced fifty per cent out there in the
last few years, friend, and is——”
“Stop, sir!” cried Enoch. “I believe we have already discussed the
question of friendship between us.”
“Oh, well now, see here, Crane.”
“In future, sir, you will address me as Mr. Crane. I trust that is clear to
you, Mr. Ford.”
“Well, suit yourself. What’s the use of our bein’ so all-fired
unfriendly? Neighbors, ain’t we? Livin’ under the same roof!”
“You are living under my roof, sir! Not I under yours! That you
continue to live there is purely due to the presence of a woman who
has had the misfortune to marry you, and a stepdaughter—thank
Heaven, she is not your daughter—whom I hope, with all my heart,
some day will be rid of you forever. You ask me for two weeks’ time.
Very well, you shall have it. I trust you fully realize your situation.
Remember, I shall hold you to your promise in regard to Miss
Moulton. Mr. Ford, I have nothing more to say to you—good
morning.”
Ford picked up his dusty derby slowly from the desk, and as slowly
rose to his feet.
Enoch, with his hands plunged deep in his trousers pockets, stood
grim and silent, gazing irritably at the floor; if he saw Ford’s
outstretched hand reach toward him slowly across the desk between
them, he did not move a muscle in recognition.
“Well, so long,” ventured Ford.
“Good morning,” repeated Enoch gruffly, without raising his head.
“Well, now, that’s too bad,” drawled Ford, slowly withdrawing his
hand. “I was just thinkin’ if you and me was to go down for a little
straight Bourbon you’d feel better.”
Enoch jerked up his head.
“Drink with you!” he exclaimed sharply. “Drink with you!” His keen
eyes blazed.
“Well, now, that wouldn’t hurt the quality of the whiskey any, would
it?” grinned Ford. “Sorter smooth down the remainin’ little rough
places between us—warm us both up into a more friendly
understandin’, seem’ I’ve agreed to do for you all any man can do for
another—give you my bona-fide guarantee.”
Enoch sprang forward, his clenched hands planted on his desk, his
face livid.
“Get out, sir!” he shouted. For an instant his voice stopped in his
throat, then broke out with a roar: “Out, sir! Out! When you have
anything more substantial to offer me than an invitation to a rum mill
I will listen to you.”
Before this volley of rage Ford backed away from him, backed out
through the door that Enoch swung open to him, and the next instant
slammed in his face with a sound that reverberated through the
whole building.

Any other man but Ebner Ford would have turned down the corridor,
dazed and insulted. As for Enoch’s door, it was not the first that had
been slammed in his face. He could recall a long list of exits in his
business career that were so alike in character they had ceased to
make any serious impression upon him. His rule had been to allow
time for the enraged person to cool off, and to tackle him again at the
earliest opportunity—preferably after luncheon, when experience
had taught him men were always in a more genial and approachable
humor.
All of his past interviews, however, had been trivial compared to this
with Enoch. He had entered his office keyed up with confidence and
exuberance, and had backed out of it under the fury of a man who
had laid bare his character and every secret detail of what he chose
to call his “own private affairs”; bad enough when he arrived but ten
times worse now as he realized the man he had to deal with.
Three things, however, were comforting. Enoch’s affirmed respect for
his wife and stepdaughter in regard to the overrent; his open, almost
paternal affection for Sue, and his word that he would give him two
weeks in which to settle with Miss Moulton. As for old Mrs. Miggs, he
decided to send her a check for half the amount out of Miss Ann’s
money and see what would happen.
That he drank his Bourbon alone on the first corner he reached, the
bartender agreeably changing another one of Miss Ann’s dollars,
only helped to sharpen his wits. He stood on the sawdusted floor of
the saloon, at the bar, hemmed in between the patched elbows of a
boatswain’s mate and a common sailor, ruminating over the
overwhelming events of the morning.
Now that he was out of Enoch’s drastic presence and voice, he felt
at his ease, and more so when he had laid another one of Miss
Ann’s dimes on the bar, freshly wiped from the beer spill, and
ordered a second Bourbon.
“Thinks a heap of girlie,” he mused. “Wa’n’t so savage about the
rent, after all.” As he thought of Sue there flashed through his mind
an idea, so sudden that he started, and his small eyes sparkled, so
perfectly logical to him that he grinned and wondered why, during the
whole of the strenuous interview, he had not thought of it before.
Instead, he had clutched at the idea of “Fairview Park,” his entire
acquaintance with its existence dating from a real-estate
advertisement he had read in a newspaper several weeks old, he
adding to its popularity and magnificence by capping the mythical
mansion of the candy king with a mansard roof worth a fortune, and
further embellishing its undesirable acres with the hope of a railroad-
station. Only the air changed in Fairview Park; the rest had lain a flat
failure for years, the home of crows and the sign-boards they
avoided, announcing the best cigar and the cheapest soap.
That Enoch would investigate the truth of his statements gave him
little apprehension. He was certain he had convinced him of his good
faith, building lots and all. What elated him now was his sudden idea
—an inspiration-and his first step in that direction took him out of the
saloon and on his way to see Lamont.
On a crowded corner in Fulton Street a newsboy bawled in his
passing ear:
“Here yer are! Git the extry, boss! All about the big club scandal——”
Ford stopped and glanced at the head-line, “Millionaire Slaps
Clubman’s Face,” and below it saw the face in question.
It was Jack Lamont’s.
CHAPTER XVI
Gossip, that imaginative, swift-footed, and altogether disreputable
slave of Hearsay, who runs amuck, distributing his pack of lies from
one telltale tongue to the next eager ear, rich in clever
exaggerations, never at a loss for more—far-reaching as contagion,
and heralding all else but the truth—seldom affects the poor.
In certain congested, poverty-stricken quarters, it is the basis of their
easy, garrulous language, and as current as their slang or their
profanity. Those who are both poor, humble, and meek are seldom
mentioned—since they do nothing to attract attention. They may be
said to be philosophers. Gossip, stealthy as the incoming tide,
sweeps wide; like the sea’s long, feathery fingers, it spreads with a
rapidity that is amazing. Gossip runs riot in a village. It tears down
streets, runs frantically up lanes, and into houses, short-cuts to the
next, flies around corners, climbs stairs, is passed over neighbors’
fences, seeks out the smallest nooks, is whispered through cracks
and keyholes, and even bawled down cellars—lest there should be
any one left below ground who has not heard the news.
Among those whom riches have thrown laughing into the lap of
luxury and elected to the pinnacles of the most expensive society,
women who move in those fashionable and exclusive circles, where
every detail of their private lives, from their gowns and jewels to their
marriages and divorces, the press so kindly keep the public informed
of—over these gossip hovers like an ill-omened forerunner of
scandal.
Scandal is the prime executioner; when scandal strikes it lays the
naked truth bare to the bone—stark, hideous, undeniable. It takes a
brave woman to stand firm in the face of scandal. Some totter and
fall at the first blow; others struggle to their feet and survive. Some
hide themselves.
There is something so frank and open about scandal that it becomes
terrible—merciless and terrifying in its exposure of plain fact The
hum of gossip may be compared to the mosquitoes, whose sting is
trivial; scandal strikes as sudden as a thunderbolt; it shatters the four
walls of a house with a single blow, and turns a search-light on its
victim in the ruins.
That “Handsome Jack” Lamont should have said what he did to
pretty Mrs. Benton as they met by chance coming out of the theatre,
and that pretty Mrs. Benton’s husband, having gone himself to-night
in search of his carriage, discovered it far down the line, signalled to
his coachman, made his way again through the waiting group of
women in theatre wraps and their escorts, and reached his wife’s
side at the precise moment to overhear Lamont’s quick question to
her, caught even her smiling, whispered promise to him—was
unfortunate. The attack followed.
Before either were aware of his presence, Benton struck Lamont a
stinging blow from behind, knocking off his hat. As he turned, Benton
struck him again—two very courageous blows for so short a little
man, red with rage and round as a keg. Pretty Mrs. Benton, who was
tall and slim—an exquisite blonde—screamed; so did several women
in the group about them, falling back upon their escorts for protection
—but by this time, Lamont had the enraged little man by the
shoulders and was shaking him like a rat, denouncing his attack as
an outrage, demanding an apology, explaining to him exactly what
he said, that nobody but a fool could have construed it otherwise,
that he was making himself ridiculous. Pretty Mrs. Benton also
explaining, and both being skilful liars in emergency, the dramatic
incident closed, to the satisfaction of the two stalwart policemen, who
had strolled up, swinging their long night-sticks—recognized Benton,
the millionaire, as being too wealthy to arrest, and Lamont as an old
friend of their chief at headquarters—dispersed the crowd with a
“G’wan now about yer business”; waited until the lady and her still
furious husband were safe in their carriage; shouted to the
coachman to move on, and a moment later followed Lamont around
the corner, where he explained the affair even more to their
satisfaction. In their plain brogue they thanked him, and expressed
their admiration over the skill with which he had pinioned the excited
arms of the little man; that admiration which is common among men
at prize-fights when the better of the two antagonists refuses to give
the final knockout to the weaker man.
“Sure ye had him from the first!” they both agreed.
It had all happened quickly. By the time Lamont left the two
patrolmen the theatre was dark and the doors locked for the night.

Let us discreetly draw down the dark-blue silk shades of the Benton
equipage upon the scenes that ensued on their way home. Let us
refrain from raising them even an inch to catch sight of the pretty
face of the now thoroughly indignant though tearful lady, or the
continued tirade of her lord and master, as they rumbled over the
cobbles.
Was she not lovely and convincing in her grief—and—and purely in
the right? How preposterous to think otherwise! To disagree with an
angel! Heavens! Was she not blond and adorable? Bah! How silly
husbands are! What a tempest in a teapot they make of nothing—to
misconstrue the simplest and most innocent of questions and the
most natural of whispered replies into high treason! Did not Benton
owe Mr. Lamont the most abject of apologies? Of course. He owed a
still deeper apology to Mrs. Benton for “mortifying her beyond
words.” Innocence in the hands of a brute! A lily in the grip of a
brigand! She who had given all to him—her love—her devotion—
could he doubt her for an instant? Had he ever doubted her? Had
she ever been jealous of him? How lucky he was to have a wife like
her. Henceforth he could go to the theatre alone—forever—nightly—
as long as he lived—and stay there until he died.
Passionately, with a sharp cry of contempt, she slipped off her
marriage ring, and flung it away forever on the floor of the brougham,
where he groped for it out of breath, and returned it to her
imploringly, seizing her clenched hand and begging her to let him
restore it to its rightful finger. That he restored it finally came as a
reward for a score of humble promises, including his entire belief in
her innocence, and the meekest of confessions that his undying love
for her alone had been responsible for his uncontrollable jealousy.
Her slim, satin-slippered foot still kept tapping in unison to her
beating heart, but victory was hers. It shone in her large blue eyes, in
the warm glow overspreading her delicate cheeks, her lovely throat
and neck. Her whole mind exulted as she thought of “Jack.” How she
would pour out to him in a long letter all of her pent-up heart. She
could hardly wait for morning to come in which to write it, upon the
faintly scented paper he loved, and which he could detect in his box
at the club among a dozen others by its violet hue.
After all, what had Lamont said to have raised all this tragic row? To
have been struck like a common ruffian in the public street, before
the eyes of people he knew, and several of whom he had dined with
—or hoped to—and for what?
Nine of the simplest words, all told, were what Benton had
overheard, and not a syllable more. Lamont’s quick question, “At
three, then?” and her smiling, whispered promise: “No—at three-
thirty, impatient child.”
What could have been more innocent? Has a gentleman no right to
hurriedly ask the time—and be sweetly chided for his impatience?
Far better had he refrained and discreetly sent her a note by some
trusted servant to her dressmaker’s (for he kept tally of her “fittings”)
—far better—one of those brief notes, whose very telltale briefness
reads in volumes. They are always typical of serious affairs.
Alas! the affair had only begun. The two patrolmen recounted the
incident on their return from their “beat” to the sergeant at the desk,
interspersing their narrative with good-humored laughter and some
unprintable profanity.
“’Twas him,” they said, referring to Benton. They expatiated on his
riches and the good looks of his wife, emphasized their own
magnanimity in refusing to arrest, and covered Lamont’s level,
handsome head with a wreath of glory—all to the delight of a young
reporter hanging around for an instalment, and eager to “make good”
with his night editor.
In little less than two hours the whole story was on the press—that
most powerful gossiper in the world! Needless to say, it printed the
story to a nicely—a giant high-speed press, capable of thousands of
copies an hour. It even took the trouble to fold them in great
packages, which were carried on the shoulders of men and thrown
into wagons, that dashed off to waiting trains, which in turn rushed
them to distant cities.
It made the young reporter’s reputation, but it nearly ruined pretty
Mrs. Benton’s, and brought Jack Lamont before the public eye by a
wide-spread publicity he had never dreamed of.
Needless to say, too, that the unfortunate lady did not write the note
the next morning; she became prostrated and lay in a darkened
room, and could see no one by her physician’s orders—not even her
enraged husband.
Let us pass over the heartrending details which ensued—of her
return to her mother; of their long talks of a separation, providing it
could be obtained without pecuniary loss to the injured daughter.
Both of them, you may be sure, held Benton wholly responsible—or,
rather, irresponsible, being unfit for any woman to live with, owing to
his ungovernable jealousy.
Poor Phyllis! She was born much too beautiful, with her delicate skin
like a tea-rose, and her fine, blond hair, that reached nearly to her
knees, and when up and undulated left little stray wisps at the nape
of her graceful, white neck. She should never have married a man
like Benton—round like his dollars. What a stunning pair she and
Jack Lamont would have made! But what a dance he would have led
her! Lucky he was to have the wife he had, who forgave him
everything and paid his debts and lived her own life, which was
eminently respectable, firm in her devotion to her charities, and as
set in her opinions at her women’s clubs—a small, pale woman with
large, dark eyes—a woman whom he seldom saw, never
breakfasted with, and rarely lunched or dined with at home, since he
came and went as he pleased; now and then they met at a
reception, now and then at a tea, his cheery “Hello, Nelly,” forcing
from her a “Hello, Jack,” that convinced every one around them they
were still the best of friends. Even the account of this latest affair of
his in the papers did not surprise her. For a day or two she was
annoyed by reporters, but her butler handled them cleverly, and they
went away, no wiser for having come. Not a word of reproach to her
husband passed Mrs. Lamont’s lips. If there was any money needed
over the affair, she knew Jack would come to her; further than that,
she refused to let the matter trouble her.
Nothing could have been more convincing than Lamont’s side of the
affair in the afternoon papers. This remarkable document from the
pen of a close club friend of his—a talented journalist—was
satisfactory in the extreme. It not only evoked public sympathy for
the injured lady, but put her insanely jealous husband in the light of a
man who was not responsible for his actions, and should not be
allowed to walk abroad, unless under the care of an attendant. As for
Mr. Lamont, he had done nothing or said a word that might have
been misconstrued to warrant so scandalous an attack. The same
thing might have happened to any gentleman whom common
courtesy had led to speak to a woman of his acquaintance on
leaving the theatre, and further went on to state that “Mr. Lamont’s
many virtues were vouched for by his host of friends; his fairness as
a sportsman, and his popularity in society being too widely known to
need further comment.” Lamont remained sober until he had read it;
then he went on the worst spree in ten years.

It is erroneous to suppose that men of birth and breeding seek


luxurious places to amuse themselves in. They often seek the
lowest. To a worldly and imaginative mind like Lamont’s nothing in
his own strata of society amused him at a time like this. A gentleman
may become a vagabond for days and still remain a gentleman. Men
are complex animals. The animal is simpler, wholly sincere; it
possesses but one nature; man has two—his intellectual and his
savage side—distinct one from the other, as black from white.
Women have but one nature; the ensemble of their character
changes only in rare exceptions. They are what they are born to be,
and remain so. That this nature “goes wrong” is erroneous.
Psychologically, it goes right. It reverts to its true nature at the first
real opportunity. Birth and breeding have very little to do with it.
Environment may often be likened to a jail, and since it is the nature
born of some women to crave to escape—they do. A woman who is
fundamentally saintly remains a saint. She has no desire to be
otherwise. Temptation leaves the really good alone.
Lamont, however, was a man, and a worldly man at that, a man
whose eyes were accustomed to gaze calmly at those illusive jewels
called pleasure, with their variegated facets of light, and to choose
the one whose rays most pleased him. Strange, is it not, that red has
always stood for evil?
This worst spree in ten years of his should rightly have begun with
him at Harry Hill’s, at Crosby and Houston Streets, for he had been a
familiar figure there, and a keen enthusiast over the boxing. Hill’s
white front screening the old room, with its boxes, its women, its old
bar down-stairs and its prize-ring above, had been closed by the
police. Such places, however, as Donovan’s, Dempsey’s, and
Regan’s were still wide open to receive him. Of the three he
preferred Regan’s, and, indeed, nearly the whole of his five days’
spree was spent there, down in that sordid basement, with its steep
iron stairs, its bouncer, its famous banjo player, accompanied by a
small Sunday-school melodeon; its women, its whiskey, and its
smoke. Not a breath of scandal ever entered the place, save when it
was permanently closed at last for a murder. Gentlemanly
deportment was rigorously exacted, and the first signs of trouble
meant a throw-out. It was a fine place to be forgotten in and to forget
the World above ground. This place, like Bill Monahan’s, had its
small virtues; Bill Monahan himself never touched liquor, his clean
pot of tea, which he drank from liberally, being always simmering
within his reach.
Lamont had not a single enemy at Regan’s. He spent his money
freely to the twang of one of the best banjo players the world has
ever known. That a gentleman of so much innate refinement should
have chosen a dive to amuse himself in—a place that reeked with
the odor of evil, and through whose heat, and smoke, and glaring
lights the faces of so many lost souls stared at one like spectres—
seems incredible. Where would you have him go? Back into his own
dull environment? Free and drunk as he was? Nonsense! He would
have become conspicuous. No one was ever conspicuous at
Regan’s. Hell has no favorites. The place had not sunk so low as to
have clean sawdust on its floors. It was run rigorously for coin. Its
waiters, silent, experienced, and attentive; its women, confidential in
the extreme; and the eye of the bouncer on and over them all. The
bartender, the melodeon, and the banjo player did the rest. It was
they who kept up its esprit—changed an old hard-luck story into new
luck, tears into laughter, and desperation into a faint glimmer of
hope. In the lower world everything is so well understood, there are
no novelties—stale love—stale beer—stale everything.

The last we saw of Ebner Ford was when he glanced at the extra
announcing the scandal. He who rarely bought a paper, bought this.
He handed the newsboy a nickel, waited impatiently for his change,
and leaped up the Elevated stairs, reading the account.
He read as he ran, glancing at Lamont’s portrait framed in an oval of
yacht pennants and polo-mallets, with a horseshoe for luck crowning
them all. He threw another nickel on the worn sill of the ticket
window, received a coupon from a haggard ticket-seller, and kept on
reading while he waited on the drafty station at Fulton Street for an
up-town train. Nothing could have happened to better further his
idea. Was not his friend Lamont in trouble? What better excuse to
call on him and express his sympathy? He began as he boarded the
train to frame up what he would say to him. “Sympathy first and
business afterward,” he said to himself. How he would come to him
gallantly as a friend—slap him on the back and cheer him up. “Help
him ferget—all them little worries”—and having gotten him
sufficiently cheered, talk to him man to man over his little scheme.
He told himself that there was not a chance in a thousand of its

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